Guarding the heart and protecting the brain: precise strategies for reducing the incidence of delirium in inpatients with stroke: practice in the quality control circle
守心护脑精准施策——降低脑卒中住院患者谵妄发生率品管圈实践

摘要

目的 分析神经内科脑卒中住院患者谵妄发生情况及高危因素，通过品管圈活动实施质量改进，制定并落实干预措施，降低谵妄发生率，规范防控流程，提升护理质量与患者安全。方法 选取2024年12月19日-2025年1月23日神经内科40例脑卒中患者，采用查检表普查收集谵妄发生及危险因素数据，开展现状与要因分析；结合文献设定改进目标，通过问卷调查完成真因验证，针对核心问题实施对策，比较改善前后观察指标。结果 改善前脑卒中患者谵妄发生率为35%，医源性因素与生理/躯体因素为主要危险因素，累计占比75.8%；经针对性干预后，谵妄发生率降至18%，达到预设目标。结论 品管圈活动可有效识别脑卒中患者谵妄的关键问题，通过精准干预显著降低发生率，规范防控流程，提升神经内科护理质量，值得临床推广。

Abstract

Objective To analyze the occurrence and high-risk factors of delirium in hospitalized stroke patients in the neurology department, implement quality improvement through quality control circle activities, formulate and implement intervention measures, reduce the incidence of delirium, standardize prevention and control processes, and improve nursing quality and patient safety.
Methods Forty stroke patients in the neurology department from December 19, 2024 to January 23, 2025 were selected, and data on delirium occurrence and risk factors were collected through a questionnaire survey. The current situation and factors were analyzed; Set improvement goals based on literature, conduct root cause verification through questionnaire surveys, implement countermeasures for core issues, and compare observation indicators before and after improvement.
Results The incidence of delirium in stroke patients was improved by 35%, with iatrogenic factors and physiological/physical factors being the main risk factors, accounting for a cumulative proportion of 75.8%; After targeted intervention, the incidence of delirium decreased to 18%, achieving the predetermined target.
Conclusion   Quality control circle activities can effectively identify the key issues of delirium in stroke patients, significantly reduce the incidence rate through precise intervention, standardize prevention and control processes, and improve the quality of neurology nursing, which is worthy of clinical promotion.